Kidney Stones

Kidney stones (calculi)
typically form when your urine becomes too concentrated, causing
crystals to separate from the urine and build up inside the kidneys.
Stones may be as small as a grain of sand or as large as a golfball.
Some stones pass out of the body without the need for intervention, but
others can cause severe pain if they become trapped in one of your
ureters (the narrow tubes that carry urine from the kidneys to the
bladder).

Risk Factors

Male, Caucasian, age 20-60

Dehydration (not drinking enough water)

A
diet too high in salt, calcium or oxalates (such as spinach,
chocolate, nuts), excess vitamin C or D or a high protein diet

Family history of kidney stones or a previous stone

Metabolic diseases (such as hyperparathyroidism or gout)

Inactive lifestyle or prolonged bed rest

Frequent urinary tract infections or other bladder problems

Inflammatory bowel disease (IBD) such as Crohn's disease

Certain rare hereditary disorders

Symptoms

Call your doctor if you experience any of the following symptoms, which may indicate a kidney stone:

Sudden intense pain in your back or side near your kidney, which may radiate towards your abdomen, groin or genitals

Nausea and/or vomiting

Blood in your urine

Frequent and painful urination

Fever,
especially if accompanied by other symptoms (may be an emergency
if a stone is blocking the ureter) Some stones cause no symptoms at
all.

Diagnosis

In
addition to taking a history and physical, your doctor may order one
of the following tests to determine if and where a stone exists:

Plain X-ray ("KUB" of the kidneys, ureters and bladder)

CT scan or IVP (Intravenous Pyelogram, a special dye test to evaluate your kidneys and ureters)

Ultrasound

Treatment

Many
kidney stones do not require treatment or will pass without
surgery. However, several procedures exist if your stone needs treatment:

Ureteroscopy with Lithotripsy
- a special videoscope is passed into the urinary tract, where the
stone can be grasped or broken into smaller pieces with a laser.

Percutaneous Nephrolithotomy -a videoscope is placed directly into the kidney from the back to break up and remove large or complicated stones.

Major surgery (nephrolithotomy) typically is reserved for a small percentage of patients when other methods are not successful.

Reducing Risk of Stone Recurrence

More
than half of those who develop one kidney stone will develop recurrent
or additional stones. Your doctor may order special urine and blood tests
to help determine how to decrease the risk of recurrence. Based upon these
results your doctor may suggest you:

Drink more water

Reduce salt and/or protein intake

Avoid foods high in oxalate

Avoid/reduce caffeine

Eat a special diet

Take special medications or antibiotics

Watch your calcium intake

Your doctor may refer you to a nutritionist for specific dietary guidelines.